Minnesota Health Insurance Marketplace

Category: State Guides Originally Posted: December 11, 2014 by HealthCare.com Staff Last modified: July 21, 2015

With most of the Affordable Care Act’s major provisions now in effect, the nation’s health insurance marketplace has undergone a significant transformation. Obamacare impacts individuals, families and small business owners alike. Most Americans are required to have minimum essential coverage unless they qualify for an exemption; however, the law is designed to make health care insurance more accessible and affordable with income-based financial assistance and one-stop shopping via state-based and federally facilitated exchanges. Meanwhile, the private marketplace remains a place to shop for quality, affordable health insurance plans that meet ACA requirements.

The following guide offers a glimpse at the various types of ACA-compliant health insurance in Minnesota, including individual and family health plans, small group health plans, coverage for high-risk applicants, mini-COBRA continuation coverage, Medicaid, and CHIP.

Health and healthcare in Minnesota

Minnesota placed 6th in United Health Foundation’s 2014 America’s Health Rankings.1 The state’s strengths include low prevalences of physical inactivity and diabetes, a high rate of high school graduation, and low rates of premature death and cardiovascular disease deaths. Minnesota’s challenges include a high prevalence of binge drinking, low per capita public health funding, and low immunization coverage among children. Although Minnesota’s prevalence of diabetes is among the lowest in the nation, nearly 310,000 adults living in the state have it.

The U.S. Department of Health and Human Services reported that 48,495 individuals in Minnesota selected a marketplace plan through the exchange from Oct. 1, 2013, through April 19, 2014.2 In 2015, the number of individuals in Minnesota enrolled in a marketplace plan increased to 59,704 during the open enrollment period.3

Minnesota individual and family health insurance

Minnesota created a state-based health insurance exchange, which launched Oct. 1, 2013. The MNsure marketplace provides coverage options for individuals and families, small businesses, and those who qualify for Medicaid and other free or low-cost health insurance programs, among others.

Those who buy health insurance through Minnesota’s exchange may be eligible for income-based subsidies, including premium tax credits that may be applied to any metal plan and cost-sharing subsidies that apply to silver plans. Individuals who go without health insurance may face a tax penalty known as the shared responsibility payment.

Minnesotans can also buy affordable, Obamacare qualified health insurance plans in the private marketplace at websites such as HealthCare.com. Check out HealthCare.com’s tax subsidy calculator to see if you qualify for a premium tax credit. If you do, visit Minnesota’s Health Insurance Exchange to apply for health insurance coverage.

Minnesota’s health insurance exchange: mnsure.org
Minnesota’s department of insurance: mn.gov/commerce/insurance

Minnesota small group health insurance plans

Minnesota’s small businesses with 50 or fewer employees may purchase small group health insurance plans through the MNsure exchange and in the private marketplace through websites such as such as HealthCare.com. Small businesses that use MNsure and have 25 or fewer employees may qualify for a Small Business Healthcare Tax Credit.

Self-employed individuals with no employees must apply for an individual health insurance plan on or away from the state’s exchange.

Minnesota state COBRA variations for small groups

The Consolidated Omnibus Reconciliation Act (COBRA) allows those employed by businesses with 20 or more employees to continue their group health insurance plan for a limited time should they lose coverage due to qualifying events such as termination of employment due to reasons other than gross misconduct, a reduction in work hours, divorce or legal separation, and loss of dependency status. To learn more about the federal COBRA program, visit dol.gov/ebsa/cobra.html.

In some states, those who work for a small business and lose health insurance coverage due to a qualifying event may be eligible for health insurance continuation through mini-COBRA or a similar state continuation program. In a few states, these programs may also be extended to those who work for larger companies and exhaust their federal COBRA continuation coverage limit. Mini-COBRA generally works like the federal COBRA continuation coverage, but its terms may vary.

Minnesota’s small group COBRA continuation variations are as follows4:

Mini-COBRA option Yes
Eligible group sizes Employer groups of  2 or more
Maximum continuation period – standard 18 months — standard for former employees
Maximum premium Increase 102 percent—the entire premium plus 2 percent for administration costs; if the cost for the group goes up, the amount you pay will also increase
State legislation reference MN Stat. Sec. 62A.16
More information health.state.mn.us/hmo/cobra.htm
Additional notes Additional maximum continuation periods apply dependent on circumstances.

Minnesota high-risk pools

It used to be that health insurance companies could deny applicants or charge them more based on health history and preexisting conditions. When the Affordable Care Act was passed in 2010, many states created federally funded preexisting condition insurance programs or accepted federal funding to assist with similar high-risk pool programs they already operated.5

The Affordable Care Act prohibits this practice for health insurance plans considered minimum essential coverage with effective dates beginning Jan. 1, 2014, and later. As such, the PCIPs and state high-risk pools created to provide health insurance for those once considered uninsurable are being phased out.

Minnesota Medicaid

Medicaid is a state health insurance program for low-income individuals under age 65, pregnant women, children, disabled individuals, and seniors over age 65; it is partially funded by the federal government. In 2014, states were given the option to accept additional federal funding and expand their Medicaid program eligibility to those who make up to 133 percent of the federal poverty level (effectively 138 percent due to how it is calculated, according to HealthCare.gov).6

Minnesota expanded its Medicaid program in 2014.7 The information below is specific to Minnesota’s Medicaid program:

The information below is specific to MassHealth, Massachusetts’ Medicaid program:

Medicaid expansion Yes
Governing agency Centers for Medicare & Medicaid
Administrator Minnesota Department of Health
How to apply mnsure.orgFor additional options, click here to visit the Minnesota Department of Health website
More information mn.gov/dhs/
Open-enrollment period Year-round in all states

Minnesota CHIP

The Children’s Health Insurance Program is a partnership between the states and federal government. CHIP provides health insurance to uninsured children who meet certain eligibility guidelines.

The information below is specific to Minnesota’s health insurance program for low-income children:

Program name MinnesotaCare
Website mn.gov/dhs/
How to apply mnsure.orgFor additional options, click here to visit the Minnesota Department of Health website
Phone number 800-657-3672
Eligibility Based on family size and income

1 United Health Foundation. 2014 America’s Health Rankings Annual Edition. “Annual State Health Rankings.” http://www.americashealthrankings.org

2 Kaiser Family Foundation http://kff.org/other/state-indicator/state-marketplace-statistics-2014/.

3 Kaiser Family Foundation http://kff.org/other/state-indicator/state-marketplace-statistics-2015/.

4 Minnesota Department of Health. “Frequently Asked Questions — COBRA and How to Continue Your Healthcare Coverage.” http://www.health.state.mn.us/hmo/cobra.htm.

5 National Conference of State Legislators. Coverage of Uninsurable Pre-Existing Conditions: State and Federal High-Risk Pools. Updated April 2014. Retrieved from http://www.ncsl.org/research/health/high-risk-pools-for-health-coverage.aspx

6 Centers for Medicare & Medicaid Services. “Medicaid Expansion & What It Means for You.” HealthCare.gov. N.D. https://www.healthcare.gov/what-if-my-state-is-not-expanding-medicaid/.

7 Centers for Medicare & Medicaid Services. “Minnesota.” Medicaid.gov. N.D. http://www.medicaid.gov/medicaid-chip-program-information/by-state/minnesota.html.